Article Impact Level: HIGH Data Quality: STRONG Summary of BMJ, e076939. https://doi.org/10.1136/bmj-2023-076939 Yaguang Wei et al.
Points
- The study investigated the association between chronic exposure to fine particulate matter (PM2.5) and the risk of first hospital admission for major cardiovascular disease (CVD) subtypes among Medicare beneficiaries 65 years and older in the US.
- Utilizing the Medicare database with records of over 59 million individuals from 2000 to 2016, the researchers linked calibrated PM2.5 predictions to participants’ residential zip codes as proxy exposure measurements.
- Findings revealed a significant increase in the relative risks of first hospital admissions for various CVD subtypes, including ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms associated with PM2.5 exposure.
- The exposure-response curve demonstrated a monotonically increased risk of composite CVD associated with PM2.5, with a relative risk of 1.29 at exposures between 9 and 10 µg/m3, encompassing the US national average of 9.7 µg/m3 during the study period.
- The study emphasized the persistent effects of PM2.5 exposure for at least three years, indicating a chronic impact on overall cardiovascular health, and suggested that there is no safe threshold for the chronic effect of PM2.5 on cardiovascular health, highlighting the potential benefits of adhering to the World Health Organization (WHO) air quality guideline.
Summary
The study assessed the relationship between chronic exposure to fine particulate matter (PM2.5) and the risk of first hospital admission for major cardiovascular disease (CVD) subtypes among Medicare fee-for-service beneficiaries aged 65 years and older in the contiguous US. The researchers utilized the Medicare database, encompassing records of over 59 million individuals from 2000 to 2016, and linked calibrated PM2.5 predictions to participants’ residential zip codes as proxy exposure measurements. The results demonstrated a significant association between PM2.5 exposure and increased relative risks of first hospital admissions for various CVD subtypes, including ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms. Notably, the exposure-response curve revealed a monotonically increased risk of composite CVD associated with PM2.5, with a relative risk of 1.29 (95% confidence interval 1.28 to 1.30) at exposures between 9 and 10 µg/m3, encompassing the US national average of 9.7 µg/m3 during the study period.
Furthermore, the study highlighted the persistence of the effects of PM2.5 exposure for at least three years, indicating a chronic impact on overall cardiovascular health. The findings suggested that there is no safe threshold for the chronic effect of PM2.5 on cardiovascular health, emphasizing the potential benefits of adhering to the World Health Organization (WHO) air quality guideline. Additionally, the study identified age, education, accessibility to healthcare, and neighborhood deprivation level as potential modifiers of susceptibility to PM2.5, underscoring the multifactorial nature of the impact of PM2.5 on cardiovascular health.
In summary, the study provided robust evidence of the detrimental effects of chronic PM2.5 exposure on cardiovascular health, emphasizing the urgent need for measures to reduce PM2.5 levels and adhere to air quality guidelines to mitigate the risk of hospital admissions for CVD subtypes among the elderly population in the US.
Link to the article: https://www.bmj.com/content/384/bmj-2023-076939; https://www.bmj.com/content/384/bmj.q517
References Wei, Y., Feng, Y., Danesh Yazdi, M., Yin, K., Castro, E., Shtein, A., Qiu, X., Peralta, A. A., Coull, B. A., Dominici, F., & Schwartz, J. D. (2024a). Corrections: Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: Population based cohort study. BMJ, e076939. https://doi.org/10.1136/bmj.q517 Wei, Y., Feng, Y., Danesh Yazdi, M., Yin, K., Castro, E., Shtein, A., Qiu, X., Peralta, A. A., Coull, B. A., Dominici, F., & Schwartz, J. D. (2024b). Exposure-response associations between chronic exposure to fine particulate matter and risks of hospital admission for major cardiovascular diseases: Population based cohort study. BMJ, e076939. https://doi.org/10.1136/bmj-2023-076939
